Combined diffusing capacity for nitric oxide and carbon monoxide as predictor of bronchiolitis obliterans syndrome following lung transplantation
Abstract Background There is a need for non-invasive parameters that are sensitive to the development of the bronchiolitis obliterans syndrome (BOS) in lung transplantation (LTx) patients. We studied whether the pulmonary diffusing capacity for inhaled nitric oxide is capable of detecting BOS stages...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-09-01
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| Series: | Respiratory Research |
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| Online Access: | http://link.springer.com/article/10.1186/s12931-018-0881-1 |
| _version_ | 1819072076717228032 |
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| author | Anna Winkler Kathrin Kahnert Jürgen Behr Claus Neurohr Nikolaus Kneidinger Rudolf Hatz Holger Dressel Thomas Radtke Rudolf A. Jörres |
| author_facet | Anna Winkler Kathrin Kahnert Jürgen Behr Claus Neurohr Nikolaus Kneidinger Rudolf Hatz Holger Dressel Thomas Radtke Rudolf A. Jörres |
| author_sort | Anna Winkler |
| collection | DOAJ |
| description | Abstract Background There is a need for non-invasive parameters that are sensitive to the development of the bronchiolitis obliterans syndrome (BOS) in lung transplantation (LTx) patients. We studied whether the pulmonary diffusing capacity for inhaled nitric oxide is capable of detecting BOS stages. Methods Sixty-one LTx patients were included into this cross-sectional study (19/29/7/3/3 in BOS stages 0/0-p/1/2/3). For analysis stages 0/0-p versus 1/2/3 (“BOS binary-early”), and stages 0/0-p/1 versus 2/3 (“BOS binary-late”) were summarized. Measurements of the combined diffusing capacity for nitric oxide (DLNO) and carbon monoxide (DLCO) were compared with spirometry and bodyplethysmography, and their relative importance was evaluated by discriminant analysis. Results Regarding the recognition of “BOS binary-early”, among spirometric parameters forced expiratory volume in 1 s (FEV1) was best, among bodyplethysmographic parameters airway resistance, and among diffusing parameters DLNO. Regarding “BOS binary-late”, DLNO was inferior to bodyplethysmographic parameters. Conclusion Although the study comprised only measurements at a single time point and no follow-up, DLNO outperformed FEV1, the time course of which is used in detecting BOS. Together with its pathophysiological plausibility, this result suggests that the measurement of DLNO, possibly over time, could be an easily applicable tool for the monitoring of LTx patients and should be evaluated in larger studies. |
| first_indexed | 2024-12-21T17:31:59Z |
| format | Article |
| id | doaj.art-042c7bb40bcd4481b657be6adb92ab03 |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-12-21T17:31:59Z |
| publishDate | 2018-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-042c7bb40bcd4481b657be6adb92ab032022-12-21T18:55:54ZengBMCRespiratory Research1465-993X2018-09-0119111010.1186/s12931-018-0881-1Combined diffusing capacity for nitric oxide and carbon monoxide as predictor of bronchiolitis obliterans syndrome following lung transplantationAnna Winkler0Kathrin Kahnert1Jürgen Behr2Claus Neurohr3Nikolaus Kneidinger4Rudolf Hatz5Holger Dressel6Thomas Radtke7Rudolf A. Jörres8Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M), Ludwig-Maximilians-Universität MünchenDepartment of Internal Medicine V, University of Munich (LMU), Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL)Department of Internal Medicine V, University of Munich (LMU), Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL)Robert-Bosch-Hospital, Klinik SchillerhöheDepartment of Internal Medicine V, University of Munich (LMU), Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL)Department of Thoracic Surgery, University of Munich (LMU)Epidemiology, Biostatistics and Prevention Institute, University of ZurichEpidemiology, Biostatistics and Prevention Institute, University of ZurichInstitute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M), Ludwig-Maximilians-Universität MünchenAbstract Background There is a need for non-invasive parameters that are sensitive to the development of the bronchiolitis obliterans syndrome (BOS) in lung transplantation (LTx) patients. We studied whether the pulmonary diffusing capacity for inhaled nitric oxide is capable of detecting BOS stages. Methods Sixty-one LTx patients were included into this cross-sectional study (19/29/7/3/3 in BOS stages 0/0-p/1/2/3). For analysis stages 0/0-p versus 1/2/3 (“BOS binary-early”), and stages 0/0-p/1 versus 2/3 (“BOS binary-late”) were summarized. Measurements of the combined diffusing capacity for nitric oxide (DLNO) and carbon monoxide (DLCO) were compared with spirometry and bodyplethysmography, and their relative importance was evaluated by discriminant analysis. Results Regarding the recognition of “BOS binary-early”, among spirometric parameters forced expiratory volume in 1 s (FEV1) was best, among bodyplethysmographic parameters airway resistance, and among diffusing parameters DLNO. Regarding “BOS binary-late”, DLNO was inferior to bodyplethysmographic parameters. Conclusion Although the study comprised only measurements at a single time point and no follow-up, DLNO outperformed FEV1, the time course of which is used in detecting BOS. Together with its pathophysiological plausibility, this result suggests that the measurement of DLNO, possibly over time, could be an easily applicable tool for the monitoring of LTx patients and should be evaluated in larger studies.http://link.springer.com/article/10.1186/s12931-018-0881-1Lung transplantationDiffusing capacityBronchiolitis obliterans syndrome |
| spellingShingle | Anna Winkler Kathrin Kahnert Jürgen Behr Claus Neurohr Nikolaus Kneidinger Rudolf Hatz Holger Dressel Thomas Radtke Rudolf A. Jörres Combined diffusing capacity for nitric oxide and carbon monoxide as predictor of bronchiolitis obliterans syndrome following lung transplantation Respiratory Research Lung transplantation Diffusing capacity Bronchiolitis obliterans syndrome |
| title | Combined diffusing capacity for nitric oxide and carbon monoxide as predictor of bronchiolitis obliterans syndrome following lung transplantation |
| title_full | Combined diffusing capacity for nitric oxide and carbon monoxide as predictor of bronchiolitis obliterans syndrome following lung transplantation |
| title_fullStr | Combined diffusing capacity for nitric oxide and carbon monoxide as predictor of bronchiolitis obliterans syndrome following lung transplantation |
| title_full_unstemmed | Combined diffusing capacity for nitric oxide and carbon monoxide as predictor of bronchiolitis obliterans syndrome following lung transplantation |
| title_short | Combined diffusing capacity for nitric oxide and carbon monoxide as predictor of bronchiolitis obliterans syndrome following lung transplantation |
| title_sort | combined diffusing capacity for nitric oxide and carbon monoxide as predictor of bronchiolitis obliterans syndrome following lung transplantation |
| topic | Lung transplantation Diffusing capacity Bronchiolitis obliterans syndrome |
| url | http://link.springer.com/article/10.1186/s12931-018-0881-1 |
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